Infant and Young Child Feeding Practice among Mothers in Rural Areas of Gazipur District, Bangladesh

A cross-sectional, descriptive study was conducted among 599 mothers who had at least one child aged 0– 23 month to determine infant and young child feeding practice (IYCF) in rural areas of Bangladesh. The study was conducted between November 2019 and March 2020 in rural areas of Gazipur district. A pre-tested semi-structured questionnaire was used to collect data. Out of 599 respondents, the majority (62.93%) were in the 21-30 years age-group. Only 6.67% were illiterate and the rest of the respondents were literate with different levels of education. About one third (33.38%) of the respondents had monthly income between BDT 5001-15000. 27% of the mothers could not give colostrum to the babies; half of them (50%) mentioned that baby could not suck well, while 43.83% mentioned being advised by the elders (not to give colostrum) and 6.17% mentioned their own illness. Pre-lacteal feeding practice was observed among 27% mothers and common pre-lacteal food was honey (61.25%), sugar water (35.63%) and animal milk (4.32%). Breastfeeding was initiated within the first hour of birth among 73.29% of mothers. 53.26% percent of mothers practice exclusive breastfeeding (EBF). Difficulties faced by mothers for EBF are insufficient secretion of breast milk (46.42%), not having knowledge about EBF (42.51%), and mother’s illness (11.07%). Most of the mothers (81.63%) gave complementary feeding in the correct time (6 months) and predominant complementary food was Khichuri (51.91%); however, most of them (60.77%) gave complementary food ≤3 times in a day. Our data suggests that the practice of IYCF was not optimum among the rural mothers. To improve this condition, it is necessary to motivate mothers through proper health education about the positive impacts of IYCF on child health.


Introduction
Infant and young child feeding (IYCF) practices play a vital role in the growth and development in the early months of life. 1 The global strategy for infant and young child feeding was approved by the World Health Assembly (WHA) in May 2002 and was endorsed by UNICEF.These feeding practices are known collectively as Infant and Young Child Feeding (IYCF) practices which include breastfeeding and complementary feeding. 2 The first two years of children's lives provide a critical window of opportunity to ensure survival, growth, and development through optimum infant and young child feeding (IYCF) practices. 2,3It has been recognized worldwide that breastfeeding is beneficial for both the mother and child. 2,4Optimal feeding practices, including the initiation of breastfeeding within one CBMJ 2024 January: Vol. 13 No. 01 hour of birth, exclusive breastfeeding (EBF) for six months, 2 and continuation of breastfeeding for up to two years and beyond, with ageappropriate complementary feeding.

2,3
Complementary feeding focuses on bridging the gradual transition between 6 and 24 months from exclusive breastfeeding to solid foods eaten by the whole family alongside breastfeeding.

Results
Out of 599 respondents, the majority (62.93%) were within the 21-30 years age group and were Muslim (95.99%).Only 6.67% of the respondents were illiterate.Among literate, the majority 47.41% had primary education and the rest had higher secondary or above levels of education.
Most of the respondents were housewives (90.15%).More than half of the respondents were 348(58.00%)belonged to nuclear family, while 251(42.00%)belonged to joint family.About onethird of the respondents (33.38%) had monthly income between BDT 5,001 and15,000, while few (9.51%) had monthly income less than BDT 5,000 (Table-I).had it within 24 hours and 11.00% had it after 24 hours of delivery (Fig. 1).were found in Indian studies, 14-16 but it was higher in another study done in Bangladesh. 17Similar findings were observed in Indian and Ethiopian studies. 16,19On the other hand, our findings are slightly lower than that of other studies done in Bangladesh and India. 1,18This may be due to the difference in geographic region and lack of access to information.Those who were not giving colostrum chose honey, sugar water and animal milk instead.Honey and water are commonly used as prelacteal feeding in India. 16,18Our study revealed that, breastfeeding was initiated within the first hour of birth among 73.29% of mothers, which is consistent with the findings of other studies. 1,7,16Only 53.26% mothers practice exclusive breastfeeding (EBF) in our observation, which was unsatisfactory.
Because the finding is much less than that was reported in the Bangladesh Demographic Health Survey (BDHS) 2017-18. 20However, almost similar results were found in other studies done in the country. 1,17,21Difficulties faced by the mothers for EBF were insufficient secretion of breast milk, absence of knowledge and mother's illness.
Similar reasons were reported by several studies in India and Bangladesh.This represents the untowardness of the societies of the South Asia region. 24

Conclusion
Bangladesh is one of the resource-poor, developing countries of the world.Growth faltering and nutritional problems are common in infant and young children in low-and middleincome countries (LMICs) like Bangladesh.
Limited access of information, lack of awareness and knowledge and poor socio-economic conditions affect the practice of Infant and young child feeding (IYCF).Overall status of the infant and young child feeding was not optimum as compared to other evidence and reference data.
The results of giving colostrum within the first hour of birth were found inadequate.Colostrum feeding practice needs to be as it is the first immunization of child.Breastfeeding initiation also needs improvement because of its protective CBMJ 2024 January: Vol. 13 No. 01 effect of natural birth spacing in Bangladesh.The rate of exclusive breast feeding was also unsatisfactory.Though most of the respondents started complementary food in correct time, the types of food and frequency of feeding were not optimum.However, due to small sample size and confining to a small region of the country, our study will not represent the actual level of practice regarding infant and young child feeding

Fig. 1 :
Fig. 1: Pie chart showing Time of initiation of breast milk

Fig. 2 :
Fig. 2: Bar diagram showing reasons behind not practicing exclusive breast feeding (n=280) It may be due to better presence of awareness among the mothers residing into that specific region.Mothers who could not give colostrum due to three reasons: baby's inability to suck, no knowledge or misconception about colostrum and mother's illness.Similar studies done in India reported lack of knowledge or misconception as the prime reason.16,18Prevalence of prelacteal feeding practice of the current study were 27%.

Table -
About three-fourths of the respondents (73.00%) gave colostrum to their babies.Among the mothers who did not practice colostrum feeding, about half of them (50%) mentioned that baby could not suck well, while 43.honey as first food to the babies, followed by sugar water (35.63%) and animal milk (4.32%) instead of giving colostrum (Table-II).CBMJ 2024 January: Vol. 13 No. 01 Only 439 mothers (73.00%) had an initiation of breast milk within 1 hour of their delivery, 16%

Table - III
: Information about complementary feeding practice (n=599) 1 About three-fourth (73%) mothers gave colostrum to CBMJ 2024 January: Vol. 13 No. 01 their children in the present study.Similar results IYCF) among rural populations of the whole country, i.e., the results might not be generalized.